The world is realising that due to cultural norms, adolescents and young people often do not discuss contraception with their elders or family members. PHOTO AFP

They can curse in each other’s presence, break traffic signals in unison and smoke together, and they may at times act macho and show off their romantic escapades. But young men, like their elders, do not readily open up about reproductive issues. Parents or teachers do not discuss subjects of a sensitive nature with them. While it is the same with adolescent and young women, they are comparatively more open to confiding in each other and getting guidance.

But it seems the world may be in for a change in attitude. Young men, all over the world, are stepping up to take part in reproductive discourse.

“This is the first time I sat on an airplane. I nearly never came,” he says, sharing the long journey of how he first reached Jordan from his home in Gaza.

He explained that he was sent away and told to go back due to lack of a no objection document, but he stayed near the border and went back the next morning, and was finally let into Jordan from where he flew to Bali.

A tad bit shy by nature, he confesses that the most difficult subject to talk about with boys his age is sexuality. Yet it seems that the world is realising that due to cultural norms, adolescents and young people often do not discuss these issues with their elders or family members. With their own age group, if they feel safe enough, they can talk about the typically hushed topics too. Y-PEER, a youth network of young people from more than 700 non-profit organisations and government agencies in more than 50 countries initiated by the United Nations Fund for Population Activities (UNFPA), uses an integrated approach to work with young people on subjects like gender, contraception and reproductive health. This year the thrust of all the discussions at ICFP was how to involve youth in the process. Half of the world’s population today, which is over 3.5 billion people, is under 30, mostly living in developing countries. They need guidance on these matters and silence may not be feasible anymore.

“If you’re not on the table you’re on the menu. How do we bring the youth on the table to talk about family planning?”

Pakistan is currently the world’s seventh most populous nation, according to the registered number of Pakistani, 199,085,847 in July 2015, as per the CIA Factbook. Contraception is thus an important subject that should be included in the nation’s narrative at all levels. In Pakistan too, this working via youth strategy has found a foothold.

Muhammad Shahzad, the executive director, has in tow young leaders wherever he goes. At the ICFP, too, he is watching out for and introducing proudly bright young people from Pakistan. One of them is 24-year-old Qaisar Roonjha, who says working with and for people his age is something he just has to do. His organisation, WANG (Welfare Association for Young Generation), is youth-led, and its primary focus is to struggle for a fairer society. Important buzz words like Youth Development, Women Empowerment, Mother and Child Health, Young Girls Education, Gender justice, Peace Promotion, Youth Development and livelihood security are all highlighted on the WANG website. From Lasbela in the perilous province of Balochistan, Qaisar has come a long way.

“I have met at least 40,000 young people all over Pakistan in the last five years,” he says with pride.

He shares that the toughest subject to tackle while talking to young people in Pakistan is gender equality.

“They still seem ready to discuss contraception. At least the married ones do. But seeing women as equal partners is difficult,” adds Shahzad.

Qaisar, whose video was selected for a competition held by organisers of the ICFP, attended the high profile conference in Bali as a moderator.

Ayesha Memon, an MBA student and youth leader from Hyderabad, also won the same recognition for her video, and addressed groups of interested activists and experts at the ICFP.

“Young people need to come out of their boxes; we should not assume things can’t change.”

Sharaf Boborakhimov is no novice at engaging with his peers on some of the trickiest subjects, which especially boys never openly talk about. Originally hailing from Tajikistan, he currently lives in Sofia, Bulgaria. This graduate in International Economy joined Y-Peer in 2011.

“What we do is provide safe spaces to youth where they can talk about sensitive subjects to people their own age. The peer-to-peer methodology works in tackling these subjects. We choose each word very carefully. We have to memorise manuals to know what to say and what not to and how to approach a subject.”

He has a close eye on the Syrian crisis, has Syrian friends, and has worked in Jordan closely with Syrian refugees who have made the Zaatari Camp their permanent home.

“We specially trained couples so that they could go back in the camps and train others. The refugees are just like any other couple. All they want is peace. They are depressed and frustrated no doubt. But in them I see a vision and a hope for a better tomorrow. They need guidance about contraception too.”

Theatre-based peer education, in Sharaf’s view is most effective for youth, whether they are refugees or not, the same strategy Chanan begun with.

“Since 2009, we have recruited some 50,000 young people for Y-Peer who work with us to educate their peers in important matters like sexual and reproductive health rights and also contraception,” Shahzad shares, adding that Pakistan was the first country in Asia Pacific that introduced UNFPA’s Y-Peer program in the region in 2009.

They are working with youth across 135 districts spread all over Pakistan including its toughest regions. In Pakistan, 65 per cent of the population is under 29, and 40 per cent fall into the even narrower age bracket of 10 to 24 years, says Shahzad.

“A big focus of our work is to engage with policymakers,” he says, sharing that Chanan was part of the National Task Force of 2009 for youth policy development, and is hosting the National Secretariat for Y-Peer in Pakistan.

“There are two million people in Gaza. The blockade is continuing since two years. Aid and medical help is almost impossible. Unemployment in my people is 70 per cent; among the youth it is 55 per cent. The healthcare system is fragmented. Very few people are able to reach the government-run healthcare centres.”

“In shelters that he has worked in, two to three thousand people were staying in one school. That meant each classroom was housing at least 50 people. Men, women and children, all strangers for each other, crammed into one room. With no food and water at least for the initial days till help started trickling in. Do you think family planning is a priority for them on a hungry stomach?”

In difficult situations and at such a young age, to be taken seriously and sensitise people about contraception is an uphill task. But these young people have realised that their generation’s reproductive choices will shape future demographic trends. They are thus helping their peers make informed decisions.

Research shows that when a mother dies, the children that are left behind are more likely to grow into adults with psychological issues. PHOTO: SHIRKATGAH

KARACHI: If you ask me what the government is doing about maternal and reproductive health of women and family planning, my answer will be ‘nothing’, said Planning Commission of Pakistan population section chief Shahzad Malik.

Malik – along with members of provincial assemblies, government officials, gender activists and members of civil society – said this at an event held at the Beach Luxury hotel on Wednesday. Organised by the Shirkatgah Women’s Resource Centre, ‘Next Steps: Achieving universal access to sexual and reproductive health and rights through a coherent post-2015 framework’ was a national consultation with stakeholders.

The discourse remains relevant as ever, with an estimated 30,000 women dying every year due to birth-related mishaps. While Maternal Mortality Rate (MMR) in Pakistan may have improved – dropping from 490 in 1990 to 260 in 2010 – a lot still needs to be done. MMR is the number of women per 100,000 live births who die of pregnancy and childbirth related complications. A staggering number of abortions – somewhere between 800,000 and 900,000 – are carried out in Pakistan every year, and most of them classified as unsafe abortions. Lack of contraceptive facilities and absence of timely family planning are the major reasons, as most women getting abortions are married women getting rid of an unwanted pregnancy.

Representatives from each province shared their experiences and problems. Balochistan’s representation was sorely missing as the speakers could not make it to the event. However, some jarring issues came to the fore in the discussions, such as the fact pointed out by moderator Imran Shirvanee. “Only two political parties bothered to talk to health experts when designing the public health manifesto, before the 2013 general elections,” said Shirvanee, refusing to divulge the names of the parties.

“In Punjab, there has definitely been progress,” said Dr Zafar Ikram, provincial coordinator of the Maternal, Neo-natal and Child Health Programme, Punjab. “However, problems such as unmet need of family planning methods persist. Gestational diabetes is on the rise and there is hardly any emphasis on post-menopausal cancer.”

The problems in Khyber-Pakhtunkhwa (KP), as pointed out by MPA Arshad Umerzai, are mostly to do with the security situation. “Also, while the policies of the provincial government in KP may be commendable, a lack of coordination and strained relations between the federal and provincial governments hinders progress.”

Issues related to governance and social and demographic dynamics were also discussed, and recommendations were made to improve the situation. Some of the problems pertaining to funding owe to the confusion that still exists between provincial and the federal governments after the 18th Amendment.

As the participants pointed out, it is time for maternal health to be taken seriously, especially since research shows that when a mother dies, the children that are left behind are more likely to grow into adults with psychological issues. Such issues, experts shared, are likely to fall into extremist behaviour as well.